Ambulance service adapts

A year ago, the future of Orange Cross Ambulance was uncertain, at best.

The longtime privately run ambulance service was staring squarely at the loss of 40 percent of its business, after the City of Sheboygan decided to drop Orange Cross and turn to its own fire department to serve as the city’s primary emergency medical services provider.

Instead of closing up shop, Orange Cross officials forged ahead with a much smaller customer base. The company trimmed staff through attrition, imposed a wage freeze, opened a new base in Sheboygan Falls, and went over every line of its annual expenses to run as lean an operation as possible.

“It’s been challenging to say the least,” said Gerry Isbell, 50, the executive director for Orange Cross.

But Isbell said Orange Cross, which opened in 1979 and will celebrate its 30th anniversary in 2009, not only survived the first year in its new era, it continues to provide quality service to its remaining areas of service — Kohler, Sheboygan Falls, Howards Grove and the towns of Wilson, Sheboygan, Sheboygan Falls and Mosel. It served its 100,000th customer on Dec. 7.

“We certainly didn’t like the change, but it was something that we had to adapt (to),” Isbell said. “It was out of our control. So we just moved forward.”

Orange Cross, jointly owned by St. Nicholas Hospital and Aurora Sheboygan Memorial Medical Center, recently moved its headquarters to 1919 Ashland Ave. in Sheboygan, and also opened a 24/7 operation at the Sheboygan Falls public safety building. It also retains a hub at St. Nicholas, and is open 12 hours every day at the Ashland Avenue location.

Its average response time for service is about 9½ minutes, up from about 3 minutes last year, Isbell said. That’s because Orange Cross has to travel farther distances to get to patients, instead of being able to factor in nearby City of Sheboygan calls as in past years.

So far this year, Orange Cross saw a 37 percent drop in its calls for service, from 5,903 in 2007 to 3,699 as of Dec. 16. After the first quarter of 2008, citing the downward fall in calls, the Orange Cross staff was cut from 40 to 31, retaining 26 paramedics. None of the jobs were lost through a layoff, Isbell said.

“The expenses we really needed to hone in on to make sure that we’re down where we need to be … without jeopardizing patient care,” Isbell said. “That was our bottom line.”

Since all 911 calls in the City of Sheboygan were automatically routed to the Sheboygan Fire Department’s ambulance service, Orange Cross tried to push its own telephone number, 451-9111, to attract city customers. Isbell did not have figures of how many Sheboygan residents specifically called Orange Cross, but said “we’re starting to see an incline” in the numbers of people who do.

Orange Cross is projecting a 3 percent increase in its calls for 2009. The company, which does its own billing, has a collection rate of about 60 percent. Isbell declined to say what its budget for 2008 was; he said the 2009 budget would be finalized this week.

Rick Hlavka, 60, a dispatcher and paramedic who has been with Orange Cross since its first year, said employees were upset at first when Sheboygan started its own ambulance service, because they thought they had “been complying with everything the city demanded.”

“Other than that frustration, I think they (Orange Cross staffers) felt they could continue that job they had been doing, trying to give the best care they could to patients,” Hlavka said.

Isbell said he receives calls and cards from patients who thank them for their service. A Christmas card was delivered last week from a woman who had suffered a heart attack, who Isbell said he couldn’t name because of privacy laws, praising Orange Cross paramedics for their care.

“They’re ecstatic, they’re glad that we’re still here so they have a choice,” Isbell said.

The move to Sheboygan Falls, Isbell said, has worked out well for both Orange Cross and the city, giving the ambulance service access to more customers in that part of the county.

“We were welcomed with open arms from the community,” Isbell said.

Randy Meyer, Sheboygan Falls mayor, said Orange Cross’ service in the city has improved since it moved into the public service building. Some of the Orange Cross paramedics have joined the city’s volunteer fire department, which Meyer said has been a plus.

“Everything seems to be working really well,” Meyer said. “I’ve been really happy with it.”

Fire Chief Chris Wesendorf said the department gave up part of its kitchen to make room for Orange Cross sleeping quarters for on-duty paramedics, and the two departments have meshed well.

“I always tell people who ask me, ‘It’s kind of like a house guest.'” Wesendorf said of Orange Cross’ presence in the firehouse. “You’re not real sure when they come and stay with you.”

Since it has a three-year contract to provide service in Sheboygan County, Orange Cross is still required to advise county officials of rate increases. In February, it raised rates for most of its services, and in July, it raised its mileage fee from $11 per mile to $14.30 to compensate for higher diesel costs.

On calls where Orange Cross employees interact with City of Sheboygan paramedics, Isbell said the two sides have a good working relationship.

“Our medics, just like their medics, are professional, and where there are calls when we ask for mutual aid … we get along in a professional manner,” he said.